Niclauss Nadja, Gütgemann Ines, Dohmen Jonas, Kalff Jörg C, Lingohr Philipp
Department of General, Visceral, Vascular and Thoracic Surgery, University Hospital Bonn, 53127 Bonn, Germany.
Department of Pathology, University Hospital Bonn, 53127 Bonn, Germany.
Cancers (Basel). 2021 Nov 12;13(22):5660. doi: 10.3390/cancers13225660.
Overall survival of gastric cancer remains low, as patients are often diagnosed with advanced stage disease. In this review, we give an overview of current research on biomarkers in gastric cancer and their implementation in treatment strategies. The HER2-targeting trastuzumab is the first molecular targeted agent approved for gastric cancer treatment. Other promising biomarkers for targeted therapies that have shown relevance in clinical trials are VEGF and Claudin 18.2. Expression of MET has been shown to be a negative prognostic factor in gastric cancer. Targeting the PD-1/PD-L1 pathway with immune checkpoint inhibitors has proven efficacy in advanced gastric cancer. Recent technology advances allow the detection of circulating tumor cells that may be used as diagnostic and prognostic indicators and for therapy monitoring in gastric cancer patients. Prognostic molecular subtypes of gastric cancer have been identified using genomic data. In addition, transcriptome profiling has allowed a comprehensive characterization of the immune and stromal microenvironment in gastric cancer and development of novel risk scores. These prognostic and predictive markers highlight the rapidly evolving field of research in gastric cancer, promising improved treatment stratification and identification of molecular targets for individualized treatment in gastric cancer.
由于患者常被诊断为晚期疾病,胃癌的总体生存率仍然很低。在这篇综述中,我们概述了目前关于胃癌生物标志物的研究及其在治疗策略中的应用。靶向HER2的曲妥珠单抗是首个被批准用于胃癌治疗的分子靶向药物。在临床试验中显示出相关性的其他有前景的靶向治疗生物标志物是VEGF和Claudin 18.2。MET的表达已被证明是胃癌的一个负性预后因素。用免疫检查点抑制剂靶向PD-1/PD-L1通路已被证明在晚期胃癌中有效。最近的技术进步使得检测循环肿瘤细胞成为可能,这些细胞可用作胃癌患者的诊断和预后指标以及治疗监测。已利用基因组数据确定了胃癌的预后分子亚型。此外,转录组分析能够全面表征胃癌的免疫和基质微环境,并开发新的风险评分。这些预后和预测标志物凸显了胃癌研究领域的快速发展,有望改善治疗分层并确定胃癌个体化治疗的分子靶点。